Final Ruling on Ensuring Access to Medicaid Services

The Medicaid program, run by the Department of Health and Human Services, wants to make sure people can get the healthcare services they need. Recent government orders expressed the importance of making healthcare affordable and accessible for all. The goal is to make it easier for people to understand their healthcare options, keep track of how well they are doing, and get involved in their own care.

The Access rule focuses on simplifying information about healthcare options, monitoring the quality of care, and involving individuals with disabilities in their healthcare decisions. These efforts can lead to a more accessible, barrier-free California for all.

Here are highlights of the provisions in the final rule:

(A) Medicaid Advisory Committee and Beneficiary Advisory Council:

• States rename and expand advisory committees, including representation from Medicaid beneficiaries.
• Public sharing of committee activities required, with at least two open meetings annually.
• Staff support mandated and annual reports summarizing activities must be published.

(B) Home- and Community-Based Services (HCBS):

• States improve oversight and planning for HCBS, meeting national standards.
• Grievance system established, and reporting requirements set for service quality and accessibility.
• Public transparency promoted through sharing waiting lists and service quality measures.

(C) Fee-for-Service (FFS):

• States publish Medicaid payment rates online and compare them to Medicare rates biennially.
• Average payment rates for specific services disclosed every two years.
• Advisory group created to advise on payment rates, and access to services ensured during rate changes.

 

Check out the Centers for Medicare & Medicaid Services Newsroom for more information.